Effectiveness of Mitomycin-c Application as an Adjunct in Surgeries for Recurrent Pterygium – a Meta Analysis

Background: Recurrent pterygium poses distinct problem like high postoperative recurrences and many surgical approaches have been tried to decrease recurrences. Currently, mitomycin C (MMC) application and amniotic graft are used as adjunct apart from the standard limbal-conjunctival autograft. Aim of study: Aim of this study is to determine through meta-analysis, the risk of recurrences and frequency of post operative complications associated with MMC application over bare sclera or along with amniotic graft for recurrent pterygia. Method: A thorough search of online resources for randomised controlled clinical trials comparing bare sclera technique with or without MMC and amniotic graft with or without MMC application was done. The purpose was to determine the pooled odds ratio and 95% confidence interval for post operative pterygium recurrence. Results: Among 5 studies, 2 studies comparing bare sclera technique with or without MMC showed pooled odds ratio of 0.105 with 95% CI 0.0131 to 0.847. Study comparing amniotic graft with or without MMC showed odds ratio 0.298 with CI of 0.0817 to 1.089. Conclusion: Application of MMC on bare sclera reduced recurrence rate to 10% and on amniotic graft it reduced to 30% with no added serious complications.